Abstract
IgA deficiency is associated with high mortality (42% at 120 days) following liver transplantation (OLTx). Most of the mortality has been associated with enteric infections. Mother's milk, or human breast milk (HBM), is a rich source of IgA that is considered to have beneficial effects in terms of protection from microbial translocation and enteric infections. Two IgA-deficient OLTx recipients were given HBM orally for 10 days perioperatively. HBM was given in order to replenish intestinal IgA. Both patients had an excellent infection-free post-operative course. IgA levels in the serum rose from 5 to 10 mg/dl in one patient and from 7 to 30 mg/dl in the other. No complications from HBM administration were observed. We conclude that HBM can be used in IgA-deficient liver transplant recipients to reduce the risk of infectious complications in the post-operative period.
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References
Aniansson G, Andersson B, Alm B (1989) Protection of breast feeding against bacterial colonization of the nasopharynx: a pilot study: In Atkinson S, Hanson LA, Chandra R (eds) Human lactation, 4: breast feeding, nutrition, infection and infant growth in developed and emerging Countries. Arts Biomedical, St. John's, pp 195–205
Buckley RH (1975) Clinical and immunologic features of selective IgA deficiency. Birth Defects 11: 13
Frommel D, Moullec J, Lambin P, Fine JM (1973) Selective serum IgA deficiency. Frequency among 15 200 French blood donors. Box Sang 25: 513–518
Goldman AS, Garza C, Goldblum RM, Nichols BL (1982) Immunologic factors in the human milk during the first year of lactation. J Pediatr
Hanson LA, Ahlstedt S, Carlsson B, Fallstrom SP, Kaijser B, Lindblad BS (1978) New knowledge on human milk immunoglobulin. Acta Paediatr 67: 577
Hanson LA, Carlsson B, Cruz JR, Garcia B, Holmgren J, Shaukat R (1979) The immune response in the mammary gland. In: Ogra PL, Dayton D (eds) Immunology of breast milk. Raven Press, New York, p 168
Kanoh T, Mizumoto T, Yasuda N, Koya M, Ohno Y, Uchino H, Yoshimurac K, Ohkubo Y, Yamaguchi H (1986) Selective IgA deficiency in Japanese blood donors: frequency and statistical analysis. Box Sang 50: 81–86
Koistinen J (1975) Selective IgA deficiency in blood donors. Box Sang 29: 192
Kovar MG, Serdula MK, Marks JS, Fraser DW (1984) Review of the epidemiologic evidence for an association between infant feeding and infant health. Pediatrics 74 [Suppl]: 615–638
Robertson DM, Carlsson B, Coffman K, Hahn Zoric M, Jalil F, Soues C, Hanson LA (1988) Avidity antibody to Escherichia coli polysaccharide and diphtheria in breast milk from Swedish and Pakistani mothers. Scand J Immunol 28: 783–789
Suzuki S, Lucas A, Lucas PJ, Coombs RRA (1983) Immunologic concentrations and bacterial antibody titres in breast milk from mothers of “pre-term” and “term” infants. Acta Paediatr 72: 671–677
Van Thiel DH, Smith WI, Rabin BS, Fisher SE, Lester R (1977) A syndrome of immunoglobulin A deficiency, diabetes mellitus, malabsorption and a common HLA haplotype. Immunologic and genetic studies of forty-three family members. Ann Intern Med 86: 10
Van Thiel DH, Finkel R, Friedlander L, Gavaler JS, Wright HI, Gordan R (1992) The association of IgA but not IgG or IgM deficiency with a reduced patient and graft survival following liver transplantation. Transplantation 54: 269
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Merhav, H.J., Wright, H.I., Mieles, L.A. et al. Treatment of IgA deficiency in liver transplant recipients with human breast milk. Transpl Int 8, 327–329 (1995). https://doi.org/10.1007/BF00346889
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DOI: https://doi.org/10.1007/BF00346889